不同手术方式对超早期高血压脑出血患者术后再出血的影响

目的探讨不同手术方式对超早期高血压脑出血患者术后再出血的影响。方法选择2014年12月至2016年8月在该院接受手术治疗的超早期高血压脑出血患者112例作为研究对象,随机分为观察组与对照组各56例,观察组患者行微创穿刺血肿引流术,对照组行小骨瓣开颅血肿清除术,对比两组患者术后再出血发生情况、术后并发症发生率及术后日常生活能力分级等。结果观察组与对照组患者术后再出血率及病死率对比差异无统计学意义(P0.05);观察组与对照组患者颅内感染、肺部感染及应激性溃疡发生率对比差异无统计学意义(P0.05);与对照组对比较,观察组患者生活能力等级为Ⅰ级所占比例显著升高,Ⅴ级所占比例明显降低,差异有统计学意义(P0.05),两组Ⅱ级、Ⅳ级患者所占比例对比差异无统计学意义(P0.05)。结论微创穿刺血肿引流术与小骨瓣开颅血肿清除术治疗超早期高血压脑出血患者术后再出血发生情况相近,具体手术方式应根据患者具体病情选择。

Effect of different surgical methods on the postoperative bleeding in patients with hypertensive intracerebral hemorrhage

Objective To investigate the effects of different surgical methods on the postoperative bleeding of patients with hy‐pertensive cerebral hemorrhage .Methods Totally 112 patients with super early hypertensive cerebral hemorrhage who were treated in this hospital from December 2014 to August 2016 were selected as study subjects ,and randomly divided into observation group and control group ,the observation group underwent minimally invasive hematoma drainage ,the control group was treated by small bone flap craniotomy ,the incidence of postoperative bleeding ,postoperative complication rate and postoperative daily life ability (ADL) classification were compared between the two groups .Results There was no significant difference between the observation group and the control group in the postoperative bleeding rate and the mortality rate (P>0 .05) .There was no significant difference in the incidence of intracranial infection ,pulmonary infection and stress ulcer between the observation group and the control group (P>0 .05) .Compared with the control group ,in observation group ,the proportion of Ⅰ‐grade of life skills level increased signifi‐cantly ,the proportion of Ⅴ‐grade decreased significantly ,the difference was statistically significant (P<0 .05) ,there was no signifi‐cant difference in the proportion of patients with Ⅱ‐grade and Ⅳ‐grade (P>0 .05) .Conclusion Patients with small bone flap cra‐niotomy in treatment of hypertensive cerebral hemorrhage patients with ultra early rebleeding after the occurrence of similar drain‐age of minimally invasive hematoma ,the surgical methods should be selected according to the specific patient .